Universität zu Köln

Marconi, Lorenzo, de Bruijn, Roderick, van Werkhoven, Erik ORCID: 0000-0001-7469-7427, Beisland, Christian ORCID: 0000-0002-3216-4937, Fife, Kate, Heidenreich, Axel, Kapoor, Anil, Karam, Jose, Kauffmann, Caroline, Klatte, Tobias, Ljungberg, Boerje, Matin, Surena, Sjoberg, Daniel, Staehler, Michael, Stewart, Grant D., Tanguay, Simon, Uzzo, Robert, Welsh, Sarah, Wood, Lori, Wood, Chris and Bex, Axel (2018). External validation of a predictive model of survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. World J. Urol., 36 (12). S. 1973 - 1981. NEW YORK: SPRINGER. ISSN 1433-8726

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Abstract

IntroductionRecent trials have emphasized the importance of a precise patient selection for cytoreductive nephrectomy (CN). In 2013, a nomogram was developed for pre- and postoperative prediction of the probability of death (PoD) after CN in patients with metastatic renal cell carcinoma. To date, the single-institutional nomogram which included mostly patients from the cytokine era has not been externally validated. Our objective is to validate the predictive model in contemporary patients in the targeted therapy era.MethodsMulti-institutional European and North American data from patients who underwent CN between 2006 and 2013 were used for external validation. Variables evaluated included preoperative serum albumin and lactate dehydrogenase levels, intraoperative blood transfusions (yes/no) and postoperative pathologic stage (primary tumour and nodes). In addition, patient characteristics and MSKCC risk factors were collected. Using the original calibration indices and quantiles of the distribution of predictions, Kaplan-Meier estimates and calibration plots of observed versus predicted PoD were calculated. For the preoperative model a decision curve analysis (DCA) was performed.ResultsOf 1108 patients [median OS of 27months (95% CI 24.6-29.4)], 536 and 469 patients had full data for the validation of the pre- and postoperative models, respectively. The AUC for the pre- and postoperative model was 0.68 (95% CI 0.62-0.74) and 0.73 (95% CI 0.68-0.78), respectively. In the DCA the preoperative model performs well within threshold survival probabilities of 20-50%. Most important limitation was the retrospective collection of this external validation dataset.ConclusionsIn this external validation, the pre- and postoperative nomograms predicting PoD following CN were well calibrated. Although performance of the preoperative nomogram was lower than in the internal validation, it retains the ability to predict early death after CN.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Marconi, Lorenzo UNSPECIFIED UNSPECIFIED UNSPECIFIED de Bruijn, Roderick UNSPECIFIED UNSPECIFIED UNSPECIFIED van Werkhoven, Erik UNSPECIFIED orcid.org/0000-0001-7469-7427 UNSPECIFIED Beisland, Christian UNSPECIFIED orcid.org/0000-0002-3216-4937 UNSPECIFIED Fife, Kate UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kapoor, Anil UNSPECIFIED UNSPECIFIED UNSPECIFIED Karam, Jose UNSPECIFIED UNSPECIFIED UNSPECIFIED Kauffmann, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Klatte, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Ljungberg, Boerje UNSPECIFIED UNSPECIFIED UNSPECIFIED Matin, Surena UNSPECIFIED UNSPECIFIED UNSPECIFIED Sjoberg, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Staehler, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Stewart, Grant D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanguay, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Uzzo, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Welsh, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Wood, Lori UNSPECIFIED UNSPECIFIED UNSPECIFIED Wood, Chris UNSPECIFIED UNSPECIFIED UNSPECIFIED Bex, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164492
DOI:	10.1007/s00345-018-2427-z
Journal or Publication Title:	World J. Urol.
Volume:	36
Number:	12
Page Range:	S. 1973 - 1981
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-8726
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROGNOSTIC-FACTORS; CANCER; THERAPY Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16449